Child and Family Instruments

National System of Care (SOC) Expansion Evaluation

Documents and Forms

Document Name Document Type
Form Child and Family Child and Family Instruments Form and Instruction
Child and Family Child and Family Attachment 9 Final Child and Family level tools 12-17-14.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Child and Family Instruments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Child and Family	Child and Family	Attachment 9 Final Child and Family level tools 12-17-14.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,083	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50,322	50,322
Annual IC Time Burden (Hours)	5,959	5,959
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.